A successful transdiaphragmatic shunting for a late and recurrent pericardial effusion following coronary bypass

Although pericardial effusion (PE) is common after cardiac surgery, late and recurrent cardiac tamponade that occurs more than 5-7 days after coronary artery bypass grafting is an infrequent complication. Moreover, the treatment of PE resistant to medical therapy, percutaneous drainage and pleuro-pericardial window remains a therapeutic challenge. We report the case of a recalcitrant PE with high-daily volume outflow drainage, finally treated with success, with a transdiaphragmatic pleuro-peritoneal shunting by laparoscopic approach.